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Community Medicine in a Noncommunity Setting

NCJ Number
166715
Journal
American Jails Volume: 10 Issue: 3 Dated: (July/August 1996) Pages: 51-54
Author(s)
L Allen; Y Pruett
Date Published
1996
Length
4 pages
Annotation
This article describes the development, operation, and benefits of a correctional chronic care clinic in a 3,400-inmate correctional facility.
Abstract
The concept of a chronic care clinic stemmed from a recognition by corrections professionals that the increasing inmate population with its chronic health problems would drain available personnel and strain financial resources. The aim of the clinic was to reduce the number of medical crises that would produce unpredictable and costly responses from custodial and medical personnel. This was done by focusing on those diseases and medical conditions that require ongoing medical care. The diseases given priority by the clinic are diabetes, TB, asthma, cardiac/HTN, and seizures. As the clinic became operational, the inmates identified with these conditions were seen by the clinician for a detailed assessment of their conditions. When appropriate, other diagnostic aids were ordered, medications started, future appointments determined, and patient education reinforced. This first clinic visit allowed the clinician to create a treatment plan tailored to the inmate's specific medical condition. Some effects of the clinic operation are a decrease in sick call slips for the targeted diseases, an increase in inmates' participation in their own health care, reduced "man- down" situations associated with the targeted diseases, and treatment plans more relevant to the patient and useful to the staff. Lessons learned in the development of the clinic are the importance of cooperation between custody and medical personnel, working out details with a single clinic before expansion, gradual inmate involvement, the value of teaching the inmate the concept of managing care instead of managing crisis, and the suitability of chronic care clinics for the care of inmates with chronic diseases and aging problems.